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Here's to your health
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Stemming the spread of infectious disease
IBM and more than 20 major worldwide public health institutions, including the WHO and CDC, are working together on the Global Pandemic Initiative, a collaborative effort to help stem the spread of infectious diseases.
Estimated economic impact of an avian-influenza pandemic would be $71.3 to $166.5 billion, excluding disruptions to commerce and society, in the U.S. alone. – according to Trust for America’s Health
A mild pandemic could lead to 1.5 million human deaths globally. While a severe pandemic could bring losses of global economic output at $4.4 trillion – a global GDP decline of 12% – throwing the U.S. and the world into a deep recession. – Australia’s Lowry Institute for International Policy
Although costs in a worst-case scenario would be staggering, the indirect costs from smaller human outbreaks or even simply outbreaks among animals that result from perceptions of personal insecurity or uncertainty can have an enormous effect. We learned that lesson from the SARS outbreak. SARS resulted in approximately 700 deaths worldwide; the economic impact because of the decline in travel, tourism, and delayed investment that accompanied the outbreak in East Asia, Australia, and Canada, is estimated at $40 billion. – U.S. Department of State
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Do you know where all of your health records are? Chances are good that you don’t. As people go through their lives, they accumulate masses of medical data, including lab tests, medical history, images, treatments, prescriptions and more. Long gone are the days when most patients have one doctor treating them throughout their lives – with insurance changes, job changes, increased mobility around the world and other factors, changing physicians is almost routine. As more sophisticated tests are introduced into everyday use, the data becomes more and more complex. The challenge is to create a means for patients around the world to have access to their medical records; for doctors, hospitals and other medical care providers to know the history of the people for whom they’re caring; and for medical researchers to be able to tap into that database to learn what they can to help prevent or combat disease, pandemics and more – all while respecting security and privacy concerns.
It only seems impossible.
IBM has laid the foundation for the exchange of healthcare information. The company is confident that secure access to patient medical histories will enable patients and leaders in the healthcare arena to make better informed decisions and conduct more effective research.
IBM has long been involved with clients in the healthcare industry and in 2004, the company decided to be more aggressive in pursuing growth in this industry by focusing on healthcare providers -- hospitals, clinics and medical centers. "To help IBM grow in the provider side of healthcare, Research convened a strategy meeting in mid 2004," said Joe Jasinski, program director of the IBM Research Healthcare and Life Sciences Institute. Speakers from within the company and industry leaders were invited to speak about the problems that face healthcare today. Participants emphatically pointed to interoperability and data integration as the primary problems.
As James Kaufman, research manager of Healthcare Information Infrastructure, explains: “The world of healthcare today is similar to the world of computing in the 1970s as interoperability standards have not been widely adopted by independent software vendors.”
Some companies are interested in having that remain true, using proprietary systems to cement their businesses. Medical care is an enormous business - $1.9 trillion is spent worldwide on healthcare each year – and that amount is growing faster than the economy. However, there is a dawning realization that proprietary systems and the attendant lock on information is bad for healthcare, and that data must be mobile in some standards-based way to benefit patients and the medical industry alike. “In truth, IBM had not been moving in this direction – nor had the rest of the industry,” said Boaz Carmeli, manager of the IT for healthcare group at Haifa Research Lab.
But the strategy meeting highlighted the needs that existed and, looking out over the landscape of the marketplace, IBM realized that the demand was there – in fact, requests for proposals were already being submitted by regional factions that were interested in having interoperability. Some countries with single payer systems were already trying to build similar resources. “The market is growing algebraically and there will be more and more regional solutions that will build out as avian flu and other pandemics threaten our health,” said Kaufman. In the past, IBM had responded with custom one-off solutions rather than open solutions. That has now changed. Jasinski explained that in support of the new healthcare directions, "IBM Research has now designated our Almaden and Haifa labs as Healthcare Innovation Centers in recognition of their commitment to - and leadership in - solutions for the healthcare industry. And researchers from almost all IBM Research locations around the world are now working on a broad portfolio of projects related to healthcare and life sciences."
The technology used for IBM’s Interoperable Healthcare Information Infrastructure is based on open standards. The team uses current IBM stack software – WebSphere, enterprise services, service-oriented architecture, DB2 – adds a specific layer on top that makes it compliant with the standards and combines that with solution components that are necessary to work with the healthcare initiatives. Healthcare’s content management and discovery services systems are filled with structured data with coded systems, so it already exists in a schema that can be processed, allowing researchers to automate the discovery portion of the systems. The standards also had to be machine readable, so researchers worked with the standards bodies HL7 and IHE, for instance.
With all of that in place, “we hope to replace the 17th century paper filing system,” joked Kaufman.
But taking that first step was “like making a nice dinner,” explained Kaufman. “Now, how do you get people to come eat it?” Towards that end, IBM Research, which leads IBM’s open source strategy, took all the client-side pieces of the infrastructure and contributed that to the Eclipse Open Healthcare Framework (OHF), causing a tremendous response from many companies.
Of course, there are still those companies that want to sell their proprietary systems, but there are enlightened companies that know they will lose the vendor lock, but that new services will arise once the records are interoperable. IBM has been able to partner with many new businesses through this initiative – the ones who see IBM as the neutral vendor they want to have in the middle because IBM doesn’t compete with them in the hospital itself.
In the short-term, Kaufman and Carmeli imagine interoperability coming in a number of ways – hospitals getting together to purchase and operate an infrastructure to share data or contracting with organizations to manage the data for them, for instance.
In the future, they foresee the emergence of a new industry, one that supports the exchange of health records, reports to public health agencies, supplies individual health records to people, automates prescriptions, and more. These independent health record banks would not be owned and operated by one hospital or other entity, but would serve all interested parties.
Integrating the information in standardized ways is only the first step. Beyond that is providing advanced systems that allow doctors to search information for similar cases or researchers to investigate data that has been collected – and all under strict privacy controls. IBM is making a business out of delivering interoperability, but it goes beyond just the business benefits – creating health records that can be exchanged will be the start of a revolution in medicine.
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